Staff of the South West Regional Health Authority (SWRHA) went into panic on Wednesday night as a memorandum circulated by the Chief Executive Officer hinted at job and salary cuts.
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UWI Defends C-Section Doc
The University of the West Indies yesterday defended the doctor who performed the C-section which led to the death of a baby boy at the Mt Hope Maternity Hospital on Carnival Saturday. It also defended the absence of two of its consultants who are attached to the North Central Regional Health Authority (NCRHA). The defence came in the face of a barrage of media reports and public debate over whether the doctor who performed the surgery on expectant mother, Quelly Ann Cottle, was qualified to do so without help from the consultants.
The child, who was to be named Simeon, died after being cut on the head during the surgery. The NCRHA has since suspended the doctor with basic pay pending a full probe into the matter. Health Minister Fuad Khan is also now in the process of establishing an independent team to investigate the matter, having received a preliminary report from the NCRHA.
But in a statement yesterday, UWI insisted that proper operating procedures were followed and the doctor was not only properly qualified to conduct the surgery but also did not need the assistance of the consultants. UWI noted that the doctor, a specialist registrar, was an experienced surgeon who, in “the last two years alone,” has performed “over 100 successful C-sections at the Mt Hope Maternity Hospital, including those for high risk pregnancies.”
Seeking to clarify working protocol, UWI said “standard practice under the Trinidad and Tobago health care system does not require an on-call consultant to be present at the time of a C-section being conducted, unless there is a special need to do so,” adding that with the operating specialist registrar’s experience “the UWI consultant who was on call, and was accessible, was not requested to be in attendance.”
Apart from noting that the on-call consultant was available but was not requested to be in attendance for the surgery, UWI said the other consultant was on pre-approved leave which the NCRHA was aware of. UWI, however, said it was saddened by the child’s death and offered condolences to the family.
Dr Petronella Manning-Alleyne, who worked for 26 years in public service and was, at the time of her formal retirement in 2008, the country’s only neo-natologist—a paediatric specialist trained to handle the most complex and high risk situations involving newborns—said she had never confronted anything of this nature. She said yesterday: “I cannot comprehend this. There is always a risk that the baby could get cut but it’s not common and there is no way I have seen something like this.”
However, Dr David Bratt, paeditrician and T&T Guardian columnist, saw the incident as a reflection of the country’s high infant mortality rate which, he said, currently stood at 25.74 deaths per 1,000. “It has gotten worse in the last ten years,” he said, adding that no explanation has been offered because “no one wants to take responsibility.” Asked about increased infant mortality rates yesterday, Khan explained that numbers may be inflated because of how “the counting takes place.”
“We include still births and babies from 24-26 weeks who we try to save,” he said. Khan said he asked the question of Unicef and learned that in other countries, baby deaths were only counted in infants over 36 weeks gestation and did not include still births. He conceded, however, that “even one death is too much” and rather than set a target for improving neo-natal fatality rates, his ministry’s aim was “to go for zero.”
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